Cognitive Assessment in Occupational Therapy: A Qualitative Analysis

Current occupational therapy practice primarily consists of informal, unstandardized methods of identifying cognitive impairments. Use of standardized assessment is infrequent. Personal and organizational barriers identified were consistent with those identified in the literature. Despite endorsing identified barriers that are perceived as constraining their use, an outlier group consistently used PBTs of functional cognition. This outlier group's negotiation of barriers presents opportunities for how to target evidence-based implementation efforts. Plain-Language Summary: This article describes occupational therapists' current practices related to the use of cognitive tests. We asked therapists about factors that affect their use of different types of formal cognitive tests; specifically, we looked at the use of pencil-and-paper cognitive tests versus tests that use simulated real-world activities to assess function. Occupational therapists reported many barriers to using cognitive tests of either type, including a lack of time, difficulty accessing tests, and unfamiliar tests that are hard to learn. Most therapists predominantly use informal methods of assessing client's cognition or pencil-and-paper screening methods. One group differed in that its members mostly used formal assessments of simulated real-world tasks to evaluate the ability to perform everyday life tasks.